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Connecticut rates for HCPCS Q4250

AmnioAmp-MP, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,098.74 / $3,098.74 / $4,721.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.56 / $3,009.35 / $3,128.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.56 / $2,979.56 / $2,979.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,979.55 / $2,979.55 / $2,979.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.55 / $2,979.55 / $2,979.55
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,532.62 / $2,979.55 / $3,091.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,747.63 / $2,979.56 / $3,128.54